Global impact of COVID-19 on stroke care

Authors

Raul G. Nogueira
Mohamad Abdalkader
Muhammed M. Qureshi
Michael R. Frankel
Ossama Yassin Mansour
Hiroshi Yamagami
Zhongming Qiu
Mehdi Farhoudi
James E. Siegler
Shadi Yaghi
Eytan Raz
Nobuyuki Sakai
Nobuyuki Ohara
Michel Piotin
Laura Mechtouff
Omer Eker
Vanessa Chalumeau
Timothy J. Kleinig
Raoul Pop
Jianmin Liu
Hugh S. Winters
Xianjin Shang
Alejandro Rodriguez Vasquez
Jordi Blasco
Juan F. Arenillas
Mario Martinez-Galdamez
Alex Brehm
Marios-Nikos Psychogios
Pedro Lylyk
Diogo C. Haussen
Alhamza R. Al-Bayati
Mahmoud H. Mohammaden
Luísa Fonseca
M. Luís Silva
Francisco Montalverne
Leonardo Renieri
Salvatore Mangiafico
Urs Fischer
Jan Gralla
Donald Frei
Chandril Chugh
Brijesh P. Mehta
Simon Nagel
Markus Mohlenbruch
Santiago Ortega-Gutierrez
Mudassir Farooqui
Ameer E. Hassan
Allan Taylor
Bertrand Lapergue
Arturo Consoli
Bruce C.V. Campbell
Malveeka Sharma
Melanie Walker
Noel Van Horn
Jens Fiehler
Huy Thang Nguyen
Quoc T. Nguyen
Daisuke Watanabe
Hao Zhang
Huynh V. Le
Viet Q. Nguyen
Ruchir Shah
Thomas Devlin
Priyank Khandelwal
Italo Linfante
Wazim Izzath
Pablo M. Lavados
Veronica V. Olavarría
Gisele Sampaio Silva
Anna Verena de Carvalho Sousa
Jawad Kirmani
Martin Bendszus
Tatsuo Amano
Ryoo Yamamoto
Ryosuke Doijiri
Naoki Tokuda
Takehiro Yamada
Tadashi Terasaki
Yukako Yazawa
Jane G. Morris
Emma Griffin
John Thornton
Pascale Lavoie
Charles Matouk
Michael D. Hill
Andrew M. Demchuk
Monika Killer-Oberpfalzer
Fadi Nahab
Dorothea Altschul
Anna Ramos-Pachón
Natalia Pérez de la Ossa
Raghid Kikano
William Boisseau
Gregory Walker
Steve M. Cordina
Ajit Puri
Anna Luisa Kuhn
Dheeraj Gandhi
Pankajavalli Ramakrishnan
Roberta Novakovic-White
Alex B. Chebl, Henry Ford Health SystemFollow
Odysseas Kargiotis
Alexandra Czap
Alicia Zha
Hesham E. Masoud
Carlos Lopez
David Ozretic
Fawaz Al-Mufti
Wenjie Zie
Zhenhui Duan
Zhengzhou Yuan
Wenguo Huang
Yonggang Hao
Jun Luo
Vladimir Kalousek
Romain Bourcier
Romain Guile
Steven Hetts
Hosam M. Al-Jehani
Adel AlHazzani
Elyar Sadeghi-Hokmabadi
Mohamed Teleb
Jeremy Payne
Jin Soo Lee
Ji Man Hong
Sung-Il Sohn
Yang-Ha Hwang
Dong Hoon Shin
Hong Gee Roh
Randy Edgell
Rakesh Khatri
Ainsley Smith
Amer Malik
David Liebeskind
Nabeel Herial
Pascal Jabbour
Pedro Magalhaes
Atilla Ozcan Ozdemir
Ozlem Aykac
Takeshi Uwatoko
Tomohisa Dembo
Hisao Shimizu
Yuri Sugiura
Fumio Miyashita
Hiroki Fukuda
Kosuke Miyake
Junsuke Shimbo
Yusuke Sugimura
Andre Beer-Furlan
Krishna Joshi
Luciana Catanese
Daniel Giansante Abud
Octavio Giansante Neto
Masoud Mehrpour
Amal Al Hashmi
Mahar Saqqur
Abdulrahman Mostafa
Johanna T. Fifi
Syed Hussain
Seby John
Rishi Gupta
Rotem Sivan-Hoffmann
Anna Reznik
Achmad Fidaus Sani
Serdar Geyik
Eşref Akıl
Anchalee Churojana
Abdoreza Ghoreishi
Mohammad Saadatnia
Ehsan Sharifipour
Alice Ma
Ken Faulder
Teddy Wu
Lester Leung
Adel Malek
Barbara Voetsch
Ajay Wakhloo
Rodrigo Rivera
Danny Moises Barrientos Iman
Aleksandra Pikula
Vasileios-Arsenios Lioutas
Gotz Thomalla
Lee Birnbaum
Paolo Machi
Gianmarco Bernava
Mollie McDermott
Dawn Kleindorfer
Ken Wong
Mary S. Patterson
Jose Antonio Fiorot
Vikram Huded
William Mack
Matthew Tenser
Clifford Eskey
Sumeet Multani
Michael Kelly
Vallabh Janardhan
Oriana Cornett
Varsha Singh
Yuichi Murayama
Maxim Mokin
Pengfei Yang
Xiaoxi Zhang
Congguo Yin
Hongxing Han
Ya Peng
Wenhuo Chen
Roberto Crosa
Michel Eli Frudit
Jeyaraj D. Pandian
Anirudh Kulkarni
Yoshiki Yagita
Yohei Takenobu
Yuji Matsumaru
Satoshi Yamada
Ryuhei Kono
Takuya Kanamaru
Hidekazu Yamazaki
Manabu Sakaguchi
Kenichi Todo
Nobuaki Yamamoto
Kazutaka Sonoda
Tomoko Yoshida
Hiroyuki Hashimoto
Ichiro Nakahara
Elena Cora
David Volders
Celina Ducroux
Ashkan Shoamanesh
Johanna Ospel
Artem Kaliaev
Saima Ahmed
Umair Rashid
Leticia C. Rebello
Vitor Mendes Pereira
Robert Fahed
Michael Chen
Sunil A. Sheth
Lina Palaiodimou
Georgios Tsivgoulis
Ronil Chandra
Feliks Koyfman
Thomas Leung
Houman Khosravani
Sushrut Dharmadhikari
Giovanni Frisullo
Paolo Calabresi
Alexander Tsiskaridze
Nino Lobjanidze
Mikayel Grigoryan
Anna Czlonkowska
Diana Aguiar de Sousa
Jelle Demeestere
Conrad Liang
Navdeep Sangha
Helmi L. Lutsep
Óscar Ayo-Martín
Antonio Cruz-Culebras
Anh D. Tran
Chang Y. Young
Charlotte Cordonnier
Francois Caparros
Maria Alonso De Lecinana
Blanca Fuentes
Dileep Yavagal
Tudor Jovin
Laurent Spelle
Jacques Moret
Pooja Khatri
Osama Zaidat
Jean Raymond
Sheila Martins
Thanh Nguyen

Document Type

Article

Publication Date

7-1-2021

Publication Title

Int J Stroke

Abstract

BACKGROUND: The COVID-19 pandemic led to profound changes in the organization of health care systems worldwide.

AIMS: We sought to measure the global impact of the COVID-19 pandemic on the volumes for mechanical thrombectomy, stroke, and intracranial hemorrhage hospitalizations over a three-month period at the height of the pandemic (1 March-31 May 2020) compared with two control three-month periods (immediately preceding and one year prior).

METHODS: Retrospective, observational, international study, across 6 continents, 40 countries, and 187 comprehensive stroke centers. The diagnoses were identified by their ICD-10 codes and/or classifications in stroke databases at participating centers.

RESULTS: The hospitalization volumes for any stroke, intracranial hemorrhage, and mechanical thrombectomy were 26,699, 4002, and 5191 in the three months immediately before versus 21,576, 3540, and 4533 during the first three pandemic months, representing declines of 19.2% (95%CI, -19.7 to -18.7), 11.5% (95%CI, -12.6 to -10.6), and 12.7% (95%CI, -13.6 to -11.8), respectively. The decreases were noted across centers with high, mid, and low COVID-19 hospitalization burden, and also across high, mid, and low volume stroke/mechanical thrombectomy centers. High-volume COVID-19 centers (-20.5%) had greater declines in mechanical thrombectomy volumes than mid- (-10.1%) and low-volume (-8.7%) centers (p < 0.0001). There was a 1.5% stroke rate across 54,366 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.9% (784/20,250) of all stroke admissions.

CONCLUSION: The COVID-19 pandemic was associated with a global decline in the volume of overall stroke hospitalizations, mechanical thrombectomy procedures, and intracranial hemorrhage admission volumes. Despite geographic variations, these volume reductions were observed regardless of COVID-19 hospitalization burden and pre-pandemic stroke/mechanical thrombectomy volumes.

Medical Subject Headings

COVID-19; Cross-Sectional Studies; Global Health; Hospitalization; Hospitals, High-Volume; Hospitals, Low-Volume; Humans; Intracranial Hemorrhages; Registries; Retrospective Studies; Stroke; Thrombectomy; Time Factors

PubMed ID

33459583

Volume

16

Issue

5

First Page

573

Last Page

584

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